FAQ Directory

If you are not currently accredited and want to learn more, contact NCQA. If you are currently accredited and want to talk to someone about your status or about renewing or adding accreditations, submit a question through My NCQA.

UM-CR 2019

Pricing is based on multiple factors. Obtain full pricing information by submitting a request through My NCQA.

HP 2020

Find the Standards and Guidelines document in the NCQA eStore.

CM 2017

Any organization that provides credentials verification services can apply for Certification if it:

• Verifies practitioner credentials for health plans, MBHOs, physician organizations or health care organizations, and
• Provides verification services for at least six months before application, and 
• Performs verification activities for at least 50% of contracted practitioners, and
• Maintains the necessary credentials documentation, policies and procedures for NCQA to conduct the survey, and
• Obtains errors and omissions insurance for $1M–$2M.

CVO

Pricing is based on multiple factors. Full pricing information can be obtained by submitting a request through My NCQA.

CVO

The Standards and Guidelines document can be found in the NCQA eStore.

CVO

NCQA CVO Certification is designed to ensure organizations can maintain a high-quality network for members and contracted clients. The standards provide a framework for adopting industry best practices to promote accurate and efficient verification of practitioner credentials—ensuring that medical organizations employ qualified professionals and align with state requirements.

CVO

NCQA CVO Certification evaluates the operations of organizations that verify practitioner credentials. Verification is accomplished through the primary source, through a recognized source or through a contracted agent of the primary source.

CVO 2016

The typical evaluation timeframe, from application submission to decision, is 12 months. This depends on the organization’s readiness, as some organizations may already be working within NCQA guidelines.

CVO

• Use the NCQA Health Plan Accreditation standards to perform a gap analysis and determine improvement areas. They provide a framework for implementing evidence-based, best practices help plans improve in areas of:
  • QI process.
  • Population health management.
  • Practitioner network and access to care.
  • Utilization management processes.
  • Credentialing and recredentialing processes.
  • Members’ rights and responsibilities.
  • Member connection.
  • Medicaid service requirements.
• Satisfy state requirements and employer needs. The standards align with many state requirements.

HP 2020

NCQA LTSS Distinction for Health Plans is a complementary program designed to support health plans coordinating LTSS. The program standards provide a framework for organizations to deliver efficient, effective person-centered care that meets people’s needs, helps keep people in their preferred setting and aligns with state requirements.

HP 2020

More than 40 organizations have earned Credentials Verification Organizations Certification. A directory of Certified organizations can be found at the NCQA Report Card.

WHP 2016